The purpose of this application is to continue a training program devoted to the study of the molecular and cellular basis of cardiovascular diseases and to the development of novel therapeutic approaches to these diseases. Our proposal builds on a strong tradition of cardiovascular research and clinical training at the University of Washington School of Medicine. This renewal application is more specifically focused on four areas of opportunity with the broader field of cardiovascular disease research: (1) Signaling and Vascular Injury; (2) Gene and Cell Therapy; (3) Genetics of Cardiovascular Risk; and (4) Biomechanics and Bioengineering. These are all areas of established strength at the University of Washington School of Medicine. This program is the major source of support for clinical fellows in Cardiology, Cardiovascular Pathology, and Vascular and Cardiothoracic Surgery who wish to spend a substantial portion of their training time acquiring the skills that are required to succeed as independent, laboratory-based principal investigators. The program also provides support for trainees with Ph.D. degrees who wish to pursue training in laboratories that have a significant focus on molecular and cellular biology and genetics of the mammalian cardiovascular system.